1992835557 NPI number — LORDS AMBULANCE SERVICE INC

Table of content: (NPI 1992835557)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992835557 NPI number — LORDS AMBULANCE SERVICE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LORDS AMBULANCE SERVICE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992835557
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 490
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CENTER OSSIPEE
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03814-0490
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-539-7585
Provider Business Mailing Address Fax Number:
603-569-6214

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
44 CENTER STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WOLFEBORO
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03894
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-569-2081
Provider Business Practice Location Address Fax Number:
603-569-6214
Provider Enumeration Date:
03/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LORD
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
C
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
603-539-7585

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  0125 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 813433 . This is a "BAY STATE HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: H002158 . This is a "CHAMPUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4620 . This is a "HEALTHSOURCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: A2377 . This is a "EMPIRE BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1714767 . This is a "MEDICAID MASS HEALTH UNYS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 3083574 . This is a "CT MEDICAID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 801736 . This is a "TUFTS HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00016493 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 22F4096 . This is a "MA BCBS MEDEX" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 40006268 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".




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